KNOW PTSD: 14 tips to get more sleep

Poor sleep is awful. Poor sleep while struggling with PTSD is doubly awful. Difficulty getting a good night’s sleep also negatively impacts how well you can manage the rest of the symptoms of PTSD. Going to bed can become the enemy. As each day draws to a close, dread can start to build because going to bed doesn’t mean drifting off to a restful night’s sleep. Going to bed can mean difficulty falling asleep, restless unrewarding sleep, frequent waking up, waking up in flashback, and nightmares. Here are 14 tips to help you improve your sleep. Many of these you may have heard before – but here’s the thing. Using these tools takes consistency and extended repetition. If you have tried any of these for a few days and seen no benefit, the issue might be that you have not given it enough time. It can also be helpful to use a number of these together every night.

7 every day sleep hygiene tips: These are useful to anyone struggling to sleep more.

1. Stop Alcohol, nicotine, and caffeine early in the day. Also, you have check that you’re not getting these through hidden sources: Chocolate and tea both have caffeine, quit smoking patches and gum have nicotine, and medicines may also contain these ingredients – check carefully.
2. Set a regular sleep schedule: Go to bed, and get up at the same time every day (yep even on weekends until good sleep returns).
3. Set the mood: Darken and cool your bedroom (if you struggle with flashbacks at night do not make the room pitch black). Put clocks out of line of sight.  Put the cellphone away out of reach.  Use white noise (even a radio set between stations and turned low can help) or sleep time apps for guided meditations of nature sounds.  Only use your bedroom (or at least your bed) for sleep or sex.  Having an office in your bedroom increases the likelihood you’ll be thinking about business as you try to drift off.
4. Have a pre-bedtime routine: figure out how you wind down best (reading, meditating, writing, a hot bath or whatever helps you chill) and do those activities for 30 minutes to an hour be going to bed.
5. Use wake-up tools at appropriate times: Get lots of sunlight early in the day. Exercise earlier in the day.  Nap early in the day (if you must nap).  Reduce your exposure to computer or phone screens in the evening (or turn on your evening screen – no blue light).  All of these things tell your body that it’s time to wake up and decrease your ability to fall asleep.
6. Manage your food and fluid intake: Move your big meal to lunch. Don’t go to bed full, but don’t go to bed hungry either.  Drink enough so you’re not thirsty but not so much you have to run to restroom during the night.
7. Don’t stay in bed if you’re not falling asleep: If after 20 minutes you’re still awake, get up and repeat your pre-bedtime routine until you again feel sleepy.

7 tips specific to helping with sleep for people struggling with PTSD.

1. Set aside time earlier in the day to intentionally work on those issues that constantly spin through your mind as you try to rest in bed. A friend (back before I became a therapist) would think constantly about the dead soldiers from his time serving in a warzone every time he attempted to sleep.  When he started intentionally and regularly spending time honoring his dead friends, he started sleeping better.  If you find those thoughts popping up when you go to bed, gently remind them that you will address them at the time you have set aside.  This is not a tool for dealing with flashbacks but for a busy mind that is still staying present.  If this causes flashbacks, stop.
2. Accept that you’re not sleeping. I know this feels counter intuitive but let me explain: You’re already not sleeping, and you are surviving not sleeping so it can be argued that you can continue to survive not sleeping.  Often when people fail to fall asleep they start listing off all the reasons they must sleep or beating themselves up for failing to sleep.  Both behaviors just about guarantee you will not sleep.  But accepting that it won’t happen and being okay with it not happening may allow you to actually relax enough to drift off.
3. Prepare for flashbacks: If you are waking up in a flashback have tools on hand to help get yourself out of the flashback: sour candy, hot sauce, or items that clearly indicate where you are. (see previous blog for more tips for getting out of flashbacks:https://healinghistorycounseling.com/know-ptsd-5-ways-to-end-a-flashback/ ).
4. Teach your bed-mate how to help (or at least what not to do). A helpful bed-mate can make getting out of a flashback or bad nightmare easier.  Get clear on what actually helps and what doesn’t and share this with your partner.  If you can become violent or otherwise unsafe it is okay to have separate sleeping arrangement while you treat your PTSD.
5. Change your sleep schedule. If nighttime is when the nightmares and flashbacks are at their worse, sleep during the day.  If your schedule can be rearranged and nothing else is working this may be a useful step.
6. Treat the PTSD. If you are not currently seeking help to resolve the PTSD consider starting this process.  PTSD can be resolved, and the sleep issues caused by it can be alleviated.
7. Talk to your physician about prescription sleep aids. But keep in mind that research repeatedly shows that the above sleep hygiene tools are more effective over the long term then the use of prescriptions.

Better sleep can often be achieved using these tools.  If you are struggling with PTSD or other major stress in your life it can also be very useful to resolve the root causes of the issue that is causing your poor sleep.  I am a therapist in Austin TX that specializes in helping people heal PTSD (Post Traumatic Stress Disorder), CSA (Childhood Sexual Abuse), and trauma.  I am trained in EMDR,  a great tool for working with these issues. If you live in the Austin Texas area, contact me to schedule a free consultation.  If you don’t live near Austin, please contact a therapist with trauma treatment skills.